Detecting and enumerating soil-transmitted helminth eggs in soil: New method development and results from field testing in Kenya and Bangladesh

PLoS Negl Trop Dis. 2017 Apr 5;11(4):e0005522. doi: 10.1371/journal.pntd.0005522. eCollection 2017 Apr.

Abstract

Globally, about 1.5 billion people are infected with at least one species of soil-transmitted helminth (STH). Soil is a critical environmental reservoir of STH, yet there is no standard method for detecting STH eggs in soil. We developed a field method for enumerating STH eggs in soil and tested the method in Bangladesh and Kenya. The US Environmental Protection Agency (EPA) method for enumerating Ascaris eggs in biosolids was modified through a series of recovery efficiency experiments; we seeded soil samples with a known number of Ascaris suum eggs and assessed the effect of protocol modifications on egg recovery. We found the use of 1% 7X as a surfactant compared to 0.1% Tween 80 significantly improved recovery efficiency (two-sided t-test, t = 5.03, p = 0.007) while other protocol modifications-including different agitation and flotation methods-did not have a significant impact. Soil texture affected the egg recovery efficiency; sandy samples resulted in higher recovery compared to loamy samples processed using the same method (two-sided t-test, t = 2.56, p = 0.083). We documented a recovery efficiency of 73% for the final improved method using loamy soil in the lab. To field test the improved method, we processed soil samples from 100 households in Bangladesh and 100 households in Kenya from June to November 2015. The prevalence of any STH (Ascaris, Trichuris or hookworm) egg in soil was 78% in Bangladesh and 37% in Kenya. The median concentration of STH eggs in soil in positive samples was 0.59 eggs/g dry soil in Bangladesh and 0.15 eggs/g dry soil in Kenya. The prevalence of STH eggs in soil was significantly higher in Bangladesh than Kenya (chi-square, χ2 = 34.39, p < 0.001) as was the concentration (Mann-Whitney, z = 7.10, p < 0.001). This new method allows for detecting STH eggs in soil in low-resource settings and could be used for standardizing soil STH detection globally.

Publication types

  • Evaluation Study

MeSH terms

  • Ancylostomatoidea / isolation & purification*
  • Animals
  • Ascariasis / epidemiology
  • Ascariasis / parasitology
  • Ascaris / isolation & purification*
  • Bangladesh / epidemiology
  • Hookworm Infections / epidemiology
  • Hookworm Infections / parasitology
  • Humans
  • Kenya / epidemiology
  • Microscopy
  • Parasite Egg Count
  • Prevalence
  • Soil / parasitology*
  • Trichuriasis / epidemiology
  • Trichuriasis / parasitology
  • Trichuris / isolation & purification*

Substances

  • Soil

Grants and funding

This research was financially supported in part by Grant OPPGD759 from the Bill & Melinda Gates Foundation to the University of California, Berkeley. It was also financially supported by the National Academy of Science and USAID (grant no. 2000004603), the National Science Foundation Graduate Research Fellowship Program, and the Minority Health and Health Disparities International Research Training Program. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.